The significance of adrenal metastases from lung carcinoma

Aim: The aim of our study was to correlate spread of the lung cancer into the adrenal glands with the progression of the primary disease. Methods: We diagnosed and confirmed adrenal metastases in 50 patients with non-small cell lung cancer (NSCLC). We correlated the site of the primary lung carcinoma with the site of the adrenal metastasis, and the adrenal metastasis pattern, ipsi-, contra-, and bilateral adrenal metastases, with the operability and number of other sites of metastatic disease. Results: Adrenal metastases were ipsilateral in 20 patients, contralateral in 15 patients and bilateral in 15 patients. An inverse incidence of contra- and bilateral metastasis was observed in 37% of operated patients, and in 71% of patients with inoperable carcinoma. The difference between both groups was statistically significant (P=0.034). Conclusions: We suggest that an isolated ipsilateral adrenal metastasis in a patient with resectable primary NSCLC could be considered (and treated) as a localized disease rather than a symptom of systemic spread.